MEDICARE: FELIPE N GUTIERREZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD61219567	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811952112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELIPE N GUTIERREZ MD

Provider Business Mailing Address
First Line	:	600 ORONDO AVE STE 1
Second Line	:
City	:	WENATCHEE
State	:	WA
Zip	:	98801-2800
Country	:	US
Telephone Number	:	509-664-0949
Fax Number	:	509-664-4590

Provider Business Practice Location Address
First Line	:	900 EASTMONT AVE
Second Line	:
City	:	EAST WENATCHEE
State	:	WA
Zip	:	98802-6602
Country	:	US
Telephone Number	:	509-662-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	02/08/2022

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